Maitham A Moslim1, Max D Lefton1, Eric A Ross2, Nicholas Mackrides3, Sanjay S Reddy4. 1. Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania. 2. Department of Biostatistics and Bioinformatics, Fox Chase Cancer Center, Philadelphia, Pennsylvania. 3. Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania. 4. Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania. Electronic address: sanjay.reddy@fccc.edu.
Abstract
BACKGROUND: Adenosquamous carcinoma (ASC) of the pancreas is a rare form of malignancy with a poor prognosis. We herein report our case series with review of the contemporary literature. METHODS: With institutional review board approval, we identified 23 patients with pancreatic ASC. RESULTS: ASC was more common in women (61%), with a median age of 73 y at presentation. The tumor was in the head of the pancreas in 65% of cases. Six cases (26%) had resectable disease, three (13%) were borderline resectable, and eight (34.7%) were locally advanced or metastatic. First-line treatment included pancreatic resection in eight cases (34.8%), concurrent neoadjuvant chemoradiation in three (13%), and neoadjuvant chemotherapy in two (8.7%). Most resected tumors had pathological T3 stage (80%). Pathological nodal disease was demonstrated in 60%, and margins were positive in three cases. Complete pathological response was not observed, although fibrosis presented in only one case (10%). Eventually, twenty patients developed metastatic disease. Overall survival is 11.5 [95% confidence interval 6, 14.5] months. CONCLUSIONS: ASC demonstrates a more aggressive malignant phenotype and carries a worse prognosis. Oncological resection is the mainstay of treatment. Neoadjuvant chemoradiation is an emerging approach in the management of ASC that has been extrapolated from the adenocarcinoma neoadjuvant trials.
BACKGROUND: Adenosquamous carcinoma (ASC) of the pancreas is a rare form of malignancy with a poor prognosis. We herein report our case series with review of the contemporary literature. METHODS: With institutional review board approval, we identified 23 patients with pancreatic ASC. RESULTS: ASC was more common in women (61%), with a median age of 73 y at presentation. The tumor was in the head of the pancreas in 65% of cases. Six cases (26%) had resectable disease, three (13%) were borderline resectable, and eight (34.7%) were locally advanced or metastatic. First-line treatment included pancreatic resection in eight cases (34.8%), concurrent neoadjuvant chemoradiation in three (13%), and neoadjuvant chemotherapy in two (8.7%). Most resected tumors had pathological T3 stage (80%). Pathological nodal disease was demonstrated in 60%, and margins were positive in three cases. Complete pathological response was not observed, although fibrosis presented in only one case (10%). Eventually, twenty patients developed metastatic disease. Overall survival is 11.5 [95% confidence interval 6, 14.5] months. CONCLUSIONS: ASC demonstrates a more aggressive malignant phenotype and carries a worse prognosis. Oncological resection is the mainstay of treatment. Neoadjuvant chemoradiation is an emerging approach in the management of ASC that has been extrapolated from the adenocarcinoma neoadjuvant trials.
Authors: Jonathan R Brody; Christina L Costantino; Magdalena Potoczek; Joseph Cozzitorto; Peter McCue; Charles J Yeo; Ralph H Hruban; Agnieszka K Witkiewicz Journal: Mod Pathol Date: 2009-03-06 Impact factor: 7.842
Authors: Diogo Turiani Hourneaux De Moura; Martin Coronel; Danielle Azevedo Chacon; Ryan Tanigawa; Dalton M Chaves; Sérgio E Matuguma; Marcos E Lera Dos Santos; José Jukemura; Eduardo Guimarâes Hourneaux De Moura Journal: Rev Gastroenterol Peru Date: 2017 Oct-Dec
Authors: I Kuji; H Sumiya; J Taki; K Nakajima; K Yokoyama; S Kinuya; K Kinuya; A Ichikawa; S Konishi; T Michigishi; N Tonami Journal: Ann Nucl Med Date: 1997-02 Impact factor: 2.668
Authors: Youn Ju Na; Ki-Nam Shim; Min Sun Cho; Sun Hee Sung; Sung-Ae Jung; Kwon Yoo; Kyu Won Chung Journal: Korean J Intern Med Date: 2011-09-13 Impact factor: 2.884
Authors: Nebojsa Skorupan; Mehwish I Ahmad; Seth M Steinberg; Jane B Trepel; Derek Cridebring; Haiyong Han; Daniel D Von Hoff; Christine Alewine Journal: Future Oncol Date: 2022-05-10 Impact factor: 3.674